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Organization
PRUITT CO. OF ADA, INC
Active
Organization
PRUITT CO. OF ADA, INC
Active
Other names
PRUITT CARE
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY PRUITT PRENTICE (OWNER/CORPORATE OFFICER/MANAGER)
(580) 332-3523
Entity
Organization
Contact information
Practice address
402 E 12TH ST, ADA, OK 74820-6602
(580) 332-3523
(580) 310-0730
Mailing address
3900 N BROADWAY AVE, ADA, OK 74820-1110
(580) 332-3523
(580) 310-0730
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
11/09/2005
Last updated
04/20/2008
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